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Breast Cancer with bone metastasis, นางสาวสิริมา พรหมอินทร์ 62170067 -…
Breast Cancer with bone metastasis
information
Thai female patient,age 54,thai nationality,thai ethnic,Buddhism,female trader occupation.
chief complain
shortness of breath, restlessness.
presen illness
Four years ago, I felt a lump on my left breast.
A year before coming to the hospital, I had pain in my left hip, had a bone scan meet bone metastasis received 10 radiotherapy sessions and relieved my pain.
One month before coming to the hospital coughing up blood and being tired get tested chest X-ray meet pleural effusion get done pleral tapping and give chemotherapy.
2 hours before coming to the hospital.shortness of breath, restlessness.
past illness
Hypertention
Gordon's11 functional health patterns
Pattern2: nutrition and metabolic
Eat less.
lose weight
Pattern3: elimination
Two days of stools onceIt looks like a small, hard lump.
pattern4: Activity and exercise
Unable to perform daily activities.
fatiuge
on oxygen mask with bag
pattern5: sleep and rest
can't sleep
pain
pattern6: selt perception and selt con
Feeling less self-esteem, thinking that it is a burden for children and husband
pattern10: coping/strees tolerance
strees
Anxiety
Nursing care plan
5.Inability to perform daily activities due to decreased ability to perform activities
1.assess the ability to perform various activities.
ADL=14point
2.Teach relatives to help patients in the right way and encourage patients to practice often by themselves.
Have the patient brush his teeth twice a day.
4.Take a shower for the patient in the morning and evening.
5.Change clothes every time it gets wet.
6.Make it easy for the patient to eat
7.Give the patient a bed panwhen urine and stool.
1.Chance of hypoxia due to anemia, reduced red blood cell count.
1.Assess for signs and symptoms of hypoxia.
2.V/S q 4-6 hr.
3.Take care fowler's position.
4.Ensuring that patients get adequate rest and limit activities during periods of breathlessness.
5.Take care On oxygen mask with bag 10Lpm
6.Follow up on laboratory results.
2.May cause complications due to Pleural effusion.
Assess breathing
2.Administer medication according to the doctor's treatment plan Lasix 20 mg IV stat.
3.Observe the symptoms of having Pleural effusion, shortness of breath, chest pain.
4.To train the patient to deep breathing)
3.Risk of insufficient nutrition due to anorexia.
Maintain cleanliness of mouth and teeth.
2.Keep your head elevated while eating to prevent food aspiration into your lungs.
3.The food should be soft and liquid.
4.If one meal is not complete Divide the food into several meals.
5.Prepare food to be appetizing.
6.Weigh the patient one to two times a week.
7.Follow up on laboratory results.
Not getting enough rest due to pain.
Pain score Assessment.
pain score = 9 point
Administer medication according to the treatment plan.
3.Provide a comfortable sleeping position with your head elevated.
4.Keep the environment quiet, avoid direct exposure to air from the air conditioner.
6.Decreased self-worth due to dependence on others.
1.Assess the patient's feelings and expressions, both verbally and behaviorally.
2.Encourage the patient to speak to the patient to see their abilities.
3.Promote good family relationships so that families and relatives understand patients.
4.Don't blame the patient when the patient does something wrong.
Patho piciology
Abnormalities of cells under the mammary glands or milk ducts
Cancer is divided into four levels.
Stage I: The cancer is smaller than 2 centimeters and has not spread to the beloved lymph nodes.
Stage II: The tumor is between two and five centimeters in size, or has spread to one of the beloved lymph nodes.
Stage III: The cancer is larger than 5 centimeters and has spread so much to the same axillary lymph nodes that they have either lumped together or become attached to nearby organs.
Stage IV The cancer can be as large as it is, but it is found to have spread to distant parts of the body, such as the bone metastasis
Treatment
radiation therapy
chemotherapy treatment
surgery
Trageted therapy
นางสาวสิริมา พรหมอินทร์ 62170067